Cardiovasc Diagn Ther. 2026 Apr 24;16(2):21. doi: 10.21037/cdt-2025-aw-537. Epub 2026 Feb 26.
ABSTRACT
BACKGROUND: The neutrophil-to-lymphocyte ratio (NLR), an easily obtained inflammatory biomarker, has an unclear relationship with the severity of coronary artery disease (CAD) in first-time coronary angiography (CAG) inpatients. This single-center retrospective study aimed to explore the correlation between the baseline NLR and the severity of coronary artery lesions measured by the Gensini score in such patients.
METHODS: Consecutive data from patients who first underwent CAG at Zhengzhou People's Hospital's Cardiology Department from July to December 2024 were used. NLR was analyzed as continuous and categorical variables for the assessment of its association with the severity of coronary artery lesions. Subgroup analyses stratified by age, gender, body mass index (BMI), diabetes mellitus (DM), hypertension, and smoking status, as well as curve fitting, were also carried out. Statistical analyses included multivariable linear regression models, restricted cubic spline (RCS) analysis, and bootstrap resampling for robustness validation.
RESULTS: Among 229 first-time CAG patients (65.9% male), smoothed curve fitting showed a linear NLR-Gensini score relationship (P for non-linearity =0.38). Covariate analysis indicated that diabetes [β=16.3, 95% confidence interval (CI): 6.91-25.69, P<0.001], smoking (β=10.23, 95% CI: 1.65-18.81, P=0.02), white blood cell (WBC) count (β=2.69, 95% CI: 1.16-4.23, P<0.001), and uric acid (β=0.04, 95% CI: 0-0.08, P=0.04) were related to higher Gensini scores, while high-density lipoprotein (HDL) (β=-20.53, 95% CI: -34.97 to -6.08, P=0.006) was associated with a lower score. NLR was significantly correlated with lesion severity both in the crude model (β=3.37, 95% CI: 1.67-5.08, P<0.001) and fully adjusted model (β=2.39, 95% CI: 0.28-4.51, P=0.02). Analyzing NLR categorically (quartiles: Q1: <1.75, Q2: 1.75-2.32, Q3: >2.32-3.48, Q4: >3.48), Q3 (β=13.70, 95% CI: 2.03-25.38, P=0.02) and Q4 (β=14.91, 95% CI: 2.28-27.53, P=0.02) had significant associations with CAD severity in the fully adjusted model, with a significant trend (P for trend=0.007).
CONCLUSIONS: Among hospitalized patients undergoing first-time CAG, the NLR is significantly associated with the severity of coronary artery lesions.
PMID:42164743 | PMC:PMC13184908 | DOI:10.21037/cdt-2025-aw-537